FN 225: Nutrition
Noy Rathakette Ph.D.
Health Professions Division
Lane Community College
Eugene, Oregon

LECTURE 4B: Carbohydrates
EXAM 2 is NEXT week (during Week 5 ) (over both parts of chapter 4), so study:
SQ 4-1
Review Quiz for Exam 2
SQ 4-2
LECTURE OUTLINE Chapter 4 part 1 and L3A and L3B
LECTURE OUTLINE Chapter 4 part 2 and L4A and L4B
FORUMS for Weeks 3 & 4



Regarding the scores on Exam 1: As you can see, many students earned high scores on Exam 1.  If you were disappointed in your score, for the next exam,
these steps that might help improve your score.  
  1. Review your lecture notes.
  2. Review the results of your Study Questions and evaluate the scoring.  Send me a message if you don’t understand something or think you were scored incorrectly.  When you do, explain to me what in the text or the Lectures lead you to select the answer you did.
    Write the correct answers in your packet as well.

  3. Take the online review quiz and review the results.
  4. Reflect and decide what you understand and write down questions you have.  Post those questions in our FORUM.
  5. Rough Draft.  On paper, write down information you think that you might want nearby while taking the test.  
  6. Organize and Condense.  Learning what to leave out of your nearby is just as important as deciding what to leave in. Use of color and organization can help you find the information when you need it during the test. 


Some of the exam questions more commonly missed were ones that were asked in a slightly different way on your Study Questions. 
For example, one exam question asked what nutrients MUST a food label state the contents (as percentages of the DVs)?  That question was #18 on page 28 in your packet.





Here's what the SYLLABUS says regarding the:

Policy about returning exams: To prevent exams from being in circulation (which would decrease their reliability as an assessment tool), you're not able to see graded exams online.  Students in campus sections are also not allowed to keep their exams. 




ACCESSING PREVIOUS MESSAGES:
If you want to see a message you've already read, click
"Participants", choose to send a message to the person, then click on "Message History" in the top right.

You can also click "Message History" while you're reading a message from someone.


FORUM:

  1. Based on our LECTURE OUTLINE'S definitions of foods that are WHOLE, PARTITIONED or REFINED, how would you label one of the foods listed on our LECTURE OUTLINE under II A.  (Pick any of the foods on the list.)

  2. During Lecture 4B, you will complete the Carbohydrate portion of page 66 in your packet "Foods and Digestion".  Was anything surprising about that?

    As you're completing page 66 in your packet, also look at page 64
    in your packet, "Food Sources of Carbohydrates, Lipids, Proteins".

  3. Do you have any other questions regarding the lectures or the study questions for week 4?


CLARIFICATION: On page 64 of your packet, take a look at what it says about sucrose and cross off a few words and add a word.  Fruits naturally have three types of sugar: glucose, fructose and also sucrose.  Some vegetables (the sweeter-tasting ones like sweet peas) also have these three sugars.

part of page 64:
CARBOHYDRATES

FOOD SOURCES

2-Sucrose
table sugar(from sugarcane or sugar beets), some fruits juices, & some vegetables.




Now continue with LECTURE OUTLINE
 (page 47 of packet).

Review: What carbohydrates can humans make?  
Humans can make both galactose (from glucose) and lactose (from combining glucose and galactose).  Humans can also make glycogen (from combining many glucose molecules).




II Processing of Foods with Carbohydrates

Page 47 of your LECTURE OUTLINE describes the definitions we'll use of foods that are WHOLE, PARTITIONED or REFINED.  Sometimes other
definitions are used, but these are the ones that we'll use.  When making juice form something like an orange, the main thing that is removed is the fibrous part of the orange.

A. From these definitions, see if you can pencil in what you think the listed foods on page 47 would be, WHOLE, PARTITIONED or REFINED.  Leave the "wheat flour" one blank.  You'll be able to fill it in later.



B. Consuming lots of refined foods can change carbohydrate intake in two important ways.  It can increase your sugar intake and decrease your fiber intake.


C. Added sugar in foods.
When trying to determine if a food is high in sugar, you can look at food label for grams of sugar.



05cokelogo
Directly below are the Nutrition Facts for a 12-ounce can of Coke.  Here the Serving Size for the Nutrition Facts is 12 ounces.
06cokefacts

Fill in these above values in the blanks of that part of your Lecture Outline.  

That 12-ounce can would have almost 10 teaspoons of sugar (39 grams of sugar divided by 4 grams per teaspoon).

Directly below are the Nutrition Facts for a 20-ounce plastic bottle of Mountain Dew.  Here the Serving Size for the Nutrition Facts is 8 ounces.
10mtndewfacts
If you drank this whole bottle of of Mountain Dew, you would be getting almost 20 teaspoons of sugar.  

(31 grams of sugar divided be 4 = almost 8 teaspoons of sugar per 8 ounces.  8 teaspoons of sugar multiplied by 2.5 servings per bottle = almost 20 teaspoons of sugar for the entire 20-ounce bottle.)




15slimfastfront

Directly below are the Nutrition Facts for a 12-ounce can of Slim Fast.  How many teaspoons of sugar would that be equal to?  I don't have a can in front of me and it could be some of that sugar is lactose.

16slimfastfacts



Watch the following Video Clip to find out how many 1-teaspoon sugar cubes are in this size Big Gulp container.  

Video Clip: Big Gulp
approximately 6 minutes
If an approximately 6-minute movie isn't showing up just above on your computer, you may not have the latest version of QuickTime on your computer.  Click here to download the newest version of Quick Time.




Above are the Nutrition Facts for an 8-ounce serving of Blueberry Yogurt.
 The 39 grams of sugar shown on the Nutrition Facts are a combination of lactose in the milk, fructose and sucrose in the blueberries and sucrose in table sugar.

22yogurtplainfacts

Above are the Nutrition Facts for an 8-ounce serving of Plain Yogurt.  There is no added sugar so the 17 grams of sugar shown on the Nutrition Facts are coming from lactose in the milk.




D. Enrichment

Page 47 in the packet tells you that if a food label uses the term enriched, it means that 5 specific nutrients are required to be added to white flour and its products as well as to white rice.  Those 5 nutrients are added at levels about what they would have been before the flour or rice was partitioned.

The Enrichment Act requires that these 5 nutrients be added to all refined grain products before they are sold, so you only see in stores white flour that says "enriched".




30breadthiamin

The brown part of the above bar chart represents the thiamin content of a slice of WHOLE wheat bread.

The green part represents
the thiamin content of a slice of white bread.  Notice they are about equal because the white flour used in the white bread is required to be enriched with thiamin, riboflavin, niacin, folic acid and iron.


31breadb6

Notice  above that a slice of WHOLE wheat bread has significantly more vitamin B6 compared to white bread because white bread is not required to be enriched with vitamin B6.

32breadcomparison
33breadcracwhetfr
Sometimes a bread looks like it would be whole grain, but actually just a small part of the flour is whole.

34brdcracwhtingred
The first ingredient of this Cracked Wheat bread is wheat flour (see above ingredient list) but that wheat flour is white.  If a bread is called "Wheat Bread", its first ingredient is probably white flour.

It says the wheat flour is unbleached.  Bleached and unbleached flour have almost the same nutrients.  Consider them equal and consider them both white flour.

35breadcrawheatfacts_
A clue that it doesn't have much whole wheat is the fiber content.
39whwhitesaraleefr

40whwhitesarleebk

You can click on the above label if you want to see a larger image.

This fiber content of this "Whole Grain White" is misleading, I think, because the first value is for TWO slices.  
The first ingredient is
ENRICHED BLEACHED FLOUR"
(white flour which it calls wheat flour, then it lists barley flour, then the B-vitamins it's enriched with including niacin, thiamin, riboflavin and folic acid and the mineral it's enriched with, iron).
The remaining ingredients are:
WATER
WHOLE GRAIN
(whole wheat flour, brown rice flour [rice flour, rice bran)
WHEAT GLUTEN
CONTAINS 2% OR LESS OF EACH OF THE FOLLOWING:
BUTTER (CREAM, SALT)
CALCIUM SULFATE
MONO- AND DIGLYCERIDES
ETHOXYLATED MONO- AND DIGLYCERIDES
SODIUM STEAROL LACTYLATE
ETC.





45wholewheat100

These days, many breads that are made entirely with WHOLE grain flour use 100% on the label.


 
Now go back to the part of page 47 in your packet where you're asked to label whether you think the listed foods are WHOLE, PARTITIONED or REFINED.  
What would you say about "wheat flour"?





There are at least two reasons why processed foods are often cheaper than whole foods.

One is that 
processed foods can be stored longer before they need to be purchased or used.  The germ in whole wheat flour has beneficial fats in it that can go rancid if not sold and used right away.  Fresh vegetables and fruits have enzymes in them that cause the food to decompose.  While the processed foods can be stored longer, the processing cause them to lose MANY beneficial nutrients.

50snowball1980
The above photo of a 1980 Twinkie (technically a Sno Ball cupcake) was taken in 2006.  The cupcake still sits in the office of the nutrition faculty at LCC.


"I see you've discovered the heirloom Twinkies."
New Yorker, January 12, 2009



A second
reason why processed foods are often cheaper than whole foods is that processing can divide a food (like corn) into many parts that then can be sold individually.  It's not the farmer who sees this profit.



Consider what happens when a farmer sells his or her corn.  That corn can then be processed into many products.

52cornrefining





53cornrefiningend

54refinedcornproducts

In his 2006 book The Omnivore's Dilemma: A Natural History of Four Meals Michael Pollan writes“Every farmer I've ever met eventually gets around to telling the story about the food industry executive who declared 'There's money to be made in food, unless you're trying to grow it.'” (page 95 of The Omnivore's Dilemma




Refining is used to obtain other additives used in food processing besides sweeteners.

Three additives make up the "fiber blend" of the pasta on the right. All 3 of these additives (inulin*, xanthum gum and pectin) are non-digestible carbohydrates made by plants, but in the case of this pasta, it takes a factory to refine them from the plants, the way it takes a factory to refine table sugar from beets or corn.

When I did a web search to find out where inulin is manufactured, I found 4 regions listed.  The majority were in
mainland China, some were in the U.S and others were in Australia and Vietnam.

Persons choosing to eat foods with inulin should watch for signs of gas and bloating, which occurs in some people. Note that the pasta also has the additive wheat gluten.  Gluten is a protein naturally found in wheat, but gluten intolerance is becoming increasingly common, including among people with diabetes.

* "Inulin" is no relation to "insulin). It gets its name from inula, a large genus of about 90 species of flowering plants in the family Asteraceae, native to Europe, Asia and Africa.


The following website shows you an alphabetical listing of additives (including the sorbitol you see in this pasta) with an evaluation of their safety: CSPI's Guide to Food Additives (Center for Science in the Public Interest).  

What it says about sorbitol is:
"Some diabetics use sorbitol-sweetened foods because it is absorbed slowly and does not cause blood sugar to increase rapidly. Moderate amounts of sorbitol are safe, but large amounts may have a strong laxative effect and even cause diarrhea."





III Digestion and Absorption of Carbohydrates

A. REVIEW.
After eating, nothing needs to happen in the digestive tract to the monosaccharides in a food like grapes because they are already small enough and they are absorbed as is.  Disaccharides in that grape or in a food like milk are broken down in the digestive tract to monosaccharides.  Grapes would have sucrose (in addition to glucose and fructose) which would be broken down in the digestive tract to glucose and fructose, which would be absorbed into the villi.  The milk would have the disaccharide lactose which would be broken down in the digestive tract to glucose and galactose.  Starch in food would be broken down in the digestive tract to glucose molecules.  Fiber in food would NOT be broken down in the digestive tract because we don't have the enzymes to do that.

B. While enjoying a snack of an apple, what carbohydrates must be enzymatically digested?
See if you can answer this using information on page 64 in your packet.


C.  After digestive enzymes have done their thing, what is absorbed into the villi?
The fiber in the apple can not be enzymatically digested. 

An apple has the monosaccharides glucose and fructose in it.  Those
monosaccharides do not need to be enzymatically digested and are absorbed as is. 

An apple ALSO has the disaccharide sucrose in it.  Sucrose is
enzymatically digested to molecules of glucose and fructose.

The Video Clip below shows Loretta Plaa, retired nutrition faculty at LCC giving a very fun explanation of the anatomy of the digestive tract.
Video Clip: Villi
approximately 12 minutes
If an approximately 12-minute movie isn't showing up just above on your computer, you may not have the latest version of QuickTime on your computer.  Click here to download the newest version of Quick Time.
55villi
Ignore what the above image says about lipids.  We'll talk about lipids next week.




The video clip below should help you fill in the blanks on page 48 regarding hydrolysis and consensation.

Video Clip: Hydrolysis and Condensation
approximately 3 minutes
features a bit of a 1962 #1 hit song by Neil Sedaka:
Breaking Up is Hard to Do
If an approximately 3-minute movie isn't showing up just above on your computer, you may not have the latest version of QuickTime on your computer.  Click here to download the newest version of Quick Time.



Now look at the chart on page 66 of your packet, "Foods and Digestion"

Which foods listed there have carbohydrates that need to be enzymatically digested?

Test yourself on the "click here" questions below.  Clicking on the correct choices will help you complete part of page 66 in your packet and will help you prepare for MYSTERY QUESTIONS as well as Exam 2.

Click here if you think Table Sugar has carbohydrate that needs to be enzymatically digested.

Click here if you think Butter has carbohydrate that needs to be enzymatically digested.

Click here if you think Soybean oil has carbohydrate that needs to be enzymatically digested.

Click here if you think Chicken has carbohydrate that needs to be enzymatically digested.

Click here if you think Eggs have carbohydrate that needs to be enzymatically digested.

Click here if you think Pinto Beans have carbohydrate that needs to be enzymatically digested.

Click here if you think Spinach has carbohydrate that needs to be enzymatically digested.

Click here if you think Peas have carbohydrate that needs to be enzymatically digested.

Click here if you think Apples have carbohydrate that needs to be enzymatically digested.

Click here if you think Pasta has carbohydrate that needs to be enzymatically digested.




You should be able to fill in the parts of the chart on page 66 in your packet that were just discussed.





D. There are two locations in the body where bacterial digestion of carbohydrates can be a problem.  One is the mouth and there other is the colon (large intestine).

As page 48 of the packet says, what happens in the mouth after eating foods with sugar is that the plaque bacteria eat the sugar (sucrose).  To use the energy in that sucrose, they break the sugar down anaerobically (without oxygen).  This is the glycolysis part of Cellular Respiration (page 
51 in packet).  

The C on page 
51 = carbon.  Cellular respiration is actually step 5 of the Wilbur Drawing.  During cellular respiration, glucose combines with oxygen (and certain enzymes).  This beaks apart the glucose releasing energy as ATP and producing C02 & H20.

Use the image below to fill in some of the other blanks
on page 51 in packet.  
61metabolism




Can you see that what is left on the teeth as a result of this anaerobic breakdown is pyruvic acid? This pyruvic acid destroys the enamel of teeth with the result being cavities.

60decay

A few of the ways to decrease your risk of cavities are:
  1. Limit refined foods with starch and sugar.
  2. Brush often
  3. Floss regularly.
  4. Have teeth routinely cleaned by a dental hygienist.


The second location in the body where bacterial digestion of carbohydrates can be a problem is in the colon.  

Humans, like most other mammals from buffalos to yaks, produce lactose for the milk to nurse their young.  It gives their milk an appealing sweet, but not overly sweet, taste.  (It has about half the concentration of sugar as the average soft drink.) 





63milkelephantsnursing
This photo of a nursing elephant, as well as the following photo, was taken by Courtney Fitzpatrick, who grew up in Eugene.  She is a doctoral student at Duke University in North Carolina and her research takes her Kenya.  


65milkelephantorphan

This is at the David Sheldrick Wildlife trust in Nairobi, an organization that cares for  orphaned elephants and then eventually reintroduces them to a specific state park in Kenya.  Apparently they have pretty high success rates, although it takes a huge amount of human hours to care for them!


The more I learn about mammals, the more I'm amazed by their diversity.  There are even flying mammals (bats).  This is a brown bat, one that is common to Oregon.


Bats often weigh less than half an ounce.  Compare them to a huge elephant!  Bat milk is from about 3-5 % carbohydrate, with most of it being lactose.  Some bats feed on pollen and nectar while others feed on insects like mosquitoes.



The enzyme lactase, made by a baby, breaks down lactose into two simpler forms of sugar (glucose and galactose), which are then absorbed into the bloodstream and provide glucose to fuel a baby's rapid growth.  While fat in the milk can provide energy for the baby's muscles, as we've discussed, glucose is the only significant fuel the human brain and nervous system usually uses.

Once a baby stops nursing, most slowly lose the ability to make lactase.  While this condition is called lactose intolerance, it's the normal condition for most of the world.  About 75% of the world's adults are lactase-deficient, including most Asians, Southeast Asians, Africans, Middle Easterners and Native Americans.  

Northern Europeans, among whom lactose intolerance is uncommon, have at least a 10,000-year history of dairying and milk consumption which is different from most of the rest of the world.  A hypothesis is that at some unknown point in time, a mutation or adaptation occurred that enabled Northern Europeans to produce the enzyme lactase and digest milk as adults. Through natural selection, the frequency of the genetic trait for lactose tolerance increased in dairying societies because individuals with this genetic trait had the advantage of being better nourished.   Not only did the milk provide protein, also their calcium absorption was increased by the lactose and the small amount of vitamin D in the milk.  In societies living closer to the equator such as in Africa, the sun's ultraviolet light helped them manufacture vitamin D.  In Northern Europe, cloud cover limits sunlight for much of the year. 

Human intestines are full of bacteria that are not lactase-deficient.  The bacteria break down lactose because they want the fuel it can provide.  This intestinal fermentation produces hydrogen and other gases and molecules that attract water. This can produce symptoms like nausea, gas, bloating, cramps and diarrhea.

For a person with lactose intolerance, symptoms begin about 30 minutes to 2 hours after eating or drinking foods containing lactose.  One term, a student told me that “lactose intolerance is one of those sliding scale things“ and she was exactly right.  The severity of symptoms depends on many factors, including the amount of lactase a person makes and the kinds of bacteria they host.  For these reason, not all people deficient in lactase have the symptoms commonly associated with lactose intolerance

We definitely do not need to drink milk as adults but what we DO need is calcium and some people find it difficult to get enough calcium without drinking milk.  Later in the term, we'll talk more about getting calcium.

Getting enough calcium if lactose intolerant:
  • Drink 1/2 cup milk WITH meals OR drink milk w/ lactase added.
  • Yogurt without added milk solids because those add lactose.  When making yogurt, sometimes milk solids are added to make it firmer.
  • Aged, hard cheese, like Parmesan because bacteria ate most of the lactose during aging
  • See the chart on page 101 of your packet for other sources of calcium.


As more parents are choosing to buy organically-grown foods, concern is developing about how they are sweetened to bring them to the level of human milk.  Organic lactose must be extracted from the milk of cows fed organic foods, and the global supplies of organic milk have been "severely stretched in the last three years, driving up the price of the lactose."

While "organic formulas, like Earth’s Best and Parent’s Choice, use organic lactose as the added sugar. Organic lactose must be extracted from organic milk, the global supplies of which have been severely stretched in the last three years, driving up the price of the lactose."  So
at least one brand of organic formula is sweetened with cane sugar, or sucrose, which is much sweeter than sugars used in other formulas.

For an All-Organic Formula, Baby, That’s Sweet.  By JULIA MOSKIN, New York Times, May 19, 2008.
... "once babies get used to its sweeter taste, they might resist less sweet formulas or solid foods; and some studies suggest that they might overeat, leading to rapid weight gain in the first year, which is often a statistical predictor of childhood obesity."


(Note from instructor: Since sucrose is half fructose while lactose is half galactose, it seems like the sucrose would taste sweeter.)



 



For those fans of Garrison Keillor's radio show Prairie Home Companion, here's a funny 3-minute sketch (with wonderful sound effects) that has a bit to do with milk:
If an approximately 3-minute movie isn't showing up just above on your computer, you may not have the latest version of QuickTime on your computer.  Click here to download the newest version of Quick Time.





Now continue with page 49 of your packet.

IV In the Body: Glucose As Fuel 

A. 
What happens to make BS Rise. 

After eating foods with carbohydrate, these carbohydrates are digested by enzymes down to monosaccharides  and these monosaccharides are absorbed into the blood.  Then the fructose & galactose are changed to glucose in liver.

  1. Sugar (glucose) then leaves bloodstream and enters cells. Insulin (a hormone made by the pancreas and secreted into the blood) helps the glucose enter the cells.
  2. IF ENERGY IS NEEDED, the glucose is split apart in body's cells to release the energy & make C02 & H20. (p. 51 in packet).
  3. IF energy is NOT needed, the glucose is stored as glycogen or changed to fat.
B. Body's Response when BS falls
  1. When your blood sugar falls, you receive messages from your brain & nervous system to eat. 
  2. If you don't eat, your body's first way of getting glucose to raise your blood sugar is to break apart the glycogen in the liver. (Glycogen in the muscles can only be used in the muscles so it doesn't get into the blood to travel to other parts of the body.

    H
    ormones that sends messages for this to happen are glucagon (made by pancreas to raise blood sugar) & epinephrine (the major stress hormone; made by pancreas to raise blood sugar).
    From the above explanation, you should now be able to answer these questions:


    What do insulin & glucagon have in common?


    How are insulin & glucagon different?

  3. If you have already used up your liver's glycogen, the next way your body has of getting glucose is to rearrange the protein in muscles into glucose.


72muscles

Which of the components of muscles are surprising to you?

So when your blood sugar falls & liver glycogen is gone, protein in muscles can be used to raise your blood sugar.

Now you should be able to list the 3 ways your body can raise your blood sugar.


C. Excesses of Glucose.  When your body has excesses of glucose because you've eaten more than you need, it gets stored as fat.   Eating lots of sugar or starch usually does not lead to sustained high blood sugar levels because insulin helps that glucose enters cells, where it can be changed to fat if the glucose is not needed.







D. Deficiencies of Glucose

  1. When your cells are deficient in glucose, it causes a buildup of ketones in blood, something that is called ketosis.  Look again at page 51 in the packet and use the image below to fill in another blank.

    74metabolism

    The Krebs Cycle is the aerobic part of Cellular Respiration, meaning that part requires oxygen.  Can you see that oxygen is added to the Krebs Cycle, but not to Glycolysis?  And can you see that the Krebs Cycle needs glucose to get started?  

    When fat is used for energy, the 2-carbon fatty acid fragments go though the Krebs Cycle.  But if glucose is not in the cells, the Krebs Cycle can't happen and the 
    2-carbon fatty acid fragments combine to make 4-carbon ketones, shown below:

    75metabolism




      1. What causes it? Now can you see that  ketosis is caused by a lack of glucos in cells?
      2. Situations leading to it- One situation that can lead to less glucose being in cells and therefore ketosis is starvation.  Another is uncontrolled diabetes because there is no enough insulin to help glucose enter cells,
      3. Symptoms of ketosis include decreased appetite as well as increased thirst & urination.  Ketones are excreted from the body by several routes, including the mouth and the urine.  Since they leave a disagreeable taste in your mouth, ketones can decrease appetite.

        In order for the kidneys to work effectively, they like substances that come their way (be they salts or sugars or ketones) to be dissolved in plenty of water.  So the kidneys signal you to drink more.  And later you urinate more
      4. Short-term ketosis itself might not be dangerous, except if diabetic or pregnant.  But if your body is in ketosis, what does this also mean is happening in the body? 

        (Hint- If you're in ketosis, it means your cells aren't getting enough glucose.  So how will your body make sure your brain gets some glucose?) 

  2. Hypoglycemia
    1. Symptoms of hypoglycemia include weakness, headache and confusion.
    2. Some people with hypoglycemia have symptoms but normal blood sugar. 

      H
      ypoglycemia may be caused by frequently changing from a low carbohydrate diet to a diet with lots of sugar.

      When a person
      rapidly eats lots of sugar, the pancreas gets a VERY URGENT message to secrete insulin.  Lots of insulin is secreted and blood sugar plunges.
    3. The cause of true hypoglycemia may be a tumor of pancreas or hepatitis of the liver or other disorder.
    4. The DIAGNOSIS of Hypoglycemia (& diabetes) is the Glucose Tolerance Test.  To find out more, watch the short Video Clip below



Video Clip: An Example of a Glucose Tolerance Test
approximately 4 minutes
If an approximately 6-minute movie isn't showing up just above on your computer, you may not have the latest version of QuickTime on your computer.  Click here to download the newest version of Quick Time.



E. Diabetes is not enough insulin or ineffective insulin.  There are two types of diabetes, Type I and Type II.
  1. People with Type I diabetes don't make enough insulin, so they must take it by injection.  Insulin cannot be taken in pill form because it's composed of proteins which would be enzymatically digested by the digestive system.

    Problems for
    Type I diabetics come from long term high blood sugar (hyperglycemia) and low cell glucose.  Capillaries are destroyed so tissues die because there aren't enough capillaries to deliver  oxygen.  This sometimes causes kidney & eye disease and heart attacks.

    Guy, the son of an LCC chemistry faculty, was diagnosed with
    Type I diabetes while still in elementary school.

    80guyswim

    He quickly learned skills at managing his disease, including pricking his finger to check and chart blood sugar levels.

    81guyfinger

    82guytest

    Guy at times uses an insulin pump.

    86guypump






  2. People with Type II diabetes make enough insulin, but that insulin is ineffective.  They are sometimes given a pill that stimulates the pancreas to make even more insulin, but that pill is not actually insulin.

    The treatment for 
    Type II diabetes has 4 parts:
    1. Diet- high in vitamins, minerals & complex carbohydrates (starch & fiber) moderate in protein, low in sugar and moderately low in fat
    2. Weight management to maintain desirable weight & improve cell's sensitivity to insulin
    3. Exercise helps to maintain a desirable WEIGHT and improves cell's sensitivity to INSULIN.
    4. Stress management
Is this different than recommendations for non-diabetics?

Rates of diabetes are exploding world-wide because all over the world, obesity is a problem. Diabetes is surging worldwide, By Marc Santora, June 18, 2006, International Herald Tribune. Here's part of what this article says:
"There are many factors driving the growth in diabetes worldwide, but most experts agree that changes in lifestyle and diet are the chief culprits, in addition to genetic predisposition. As developing countries rapidly industrialize, people tend to do work involving less physical activity. At the same time, the availability of food that is cheap but high in calories becomes more common.

"The combination causes weight gain, which leads to greater risk of developing Type 2 diabetes, the most common form of the disease. The other form, Type 1, is responsible for 5 percent to 10 percent of cases and is not associated with behavior but is believed to stem almost entirely from genetic factors."

END of L4B





































































CORRECT: The carbohydrate in an apple that needs to be enzymatically digested is sucrose.  Look at the last column on that chart.  What is absorbed into the villi after eating an apple are glucose molecules and fructose molecules.  There is also the carbohydrate fiber in an apple, but it can not be enzymatically digested.
Click here to return to Lecture.























































CORRECT: The carbohydrate in table sugar that needs to be enzymatically digested is sucrose.  Look at the last column on that chart.  What is absorbed into the villi after eating table sugar is glucose molecules and fructose molecules.
Click here to return to Lecture.























































INCORRECT: There is no carbohydrate in butter that needs to be enzymatically digested.  Butter is almost entirely fat.
Click here to return to Lecture.

























































INCORRECT: There is no carbohydrate in soybean oil that needs to be enzymatically digested.  Soybean oil is almost entirely fat.
Click here to return to Lecture.


























































INCORRECT: There is no carbohydrate in chicken that needs to be enzymatically digested.  
Click here to return to Lecture.


























































INCORRECT: There is no carbohydrate in eggs that needs to be enzymatically digested.  
Click here to return to Lecture.

























































CORRECT: The carbohydrate in pinto beans that needs to be enzymatically digested is starch.  Look at the last column on that chart.  What is absorbed into the villi after eating pinto beans is glucose molecules.  There is also the carbohydrate, fiber, in pinto beans, but it can not be enzymatically digested.
Click here to return to Lecture.



























































INCORRECT: There is no carbohydrate in spinach that needs to be enzymatically digested.  There is the carbohydrate, fiber, in spinach, but it can not be enzymatically digested.
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CORRECT: The carbohydrate in peas
that needs to be enzymatically digested is starch.  Look at the last column on that chart.  What is absorbed into the villi after eating pinto beans is glucose molecules.  There is also the carbohydrate fiber in peas, but it can not be enzymatically digested.
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CORRECT: The carbohydrate in pasta that needs to be enzymatically digested is starch.  Look at the last column on that chart.  What is absorbed into the villi after eating the pasta is glucose molecules. 
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